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  • Writer's pictureJo Leccacorvi

Understanding and Managing Urinary Issues During Perimenopause

Perimenopause, the transitional phase leading up to menopause, is marked by a variety of physical and emotional changes. Among these, urinary issues can be particularly distressing. As hormone levels fluctuate, many women experience symptoms like increased frequency, urgency, and even urinary tract infections (UTIs). This blog will delve into why these urinary issues occur during perimenopause, offer nutritional advice to help manage these symptoms, and emphasize the importance of consulting your General Practitioner (GP) when necessary.


Why Do Urinary Issues Occur During Perimenopause?

Urinary issues during perimenopause are primarily driven by hormonal changes, particularly the decline in oestrogen. Oestrogen plays a vital role in maintaining the health and function of the urinary tract. As oestrogen levels drop, the tissues in the bladder and urethra can become thinner, drier, and less elastic. This can lead to a variety of symptoms:


1. Increased Frequency and Urgency: The need to urinate more often or urgently can become more common as the bladder lining thins and becomes more sensitive.

2. Incontinence: Stress incontinence (leakage when coughing, sneezing, or exercising) or urge incontinence (a sudden, intense urge to urinate followed by involuntary leakage) may develop.

3. Urinary Tract Infections (UTIs): Changes in the vaginal flora and urinary tract environment can make infections more likely.

4. Nocturia: Waking up frequently during the night to urinate.


Nutritional Strategies to Manage Urinary Issues

Diet can play a significant role in managing urinary symptoms. Here are some nutritional strategies that may help:


1. Stay Hydrated

While it might seem counterintuitive, drinking enough water is crucial. Dehydration can concentrate urine, irritating the bladder and worsening symptoms. Aim for at least 8 glasses of water a day but adjust according to your body’s needs and activity level.

2. Avoid Bladder Irritants

Certain foods and beverages can irritate the bladder. Common culprits include: -

  • Caffeine: Found in coffee, tea, chocolate, and some medications, caffeine is a diuretic and bladder stimulant.

  • Alcohol: Alcohol can irritate the bladder and increase urine production.

  • Spicy Foods: Can cause bladder discomfort in some individuals.

  • Certain Foods and Drinks: Citrus fruits, tomatoes, and carbonated beverages can exacerbate symptoms. Triggers will vary from person to person, the best way to work out your triggers is to keep a food diary. By keeping track of what you eat and drink it can help you see any correlation between what you have consumed and any symptoms you have. This can also be useful information for when and when you need to see your doctor.


3. Incorporate Oestrogen-Rich Foods

Phytoestrogens are plant compounds that mimic oestrogen in the body. Including these in your diet might help mitigate some of the symptoms associated with oestrogen decline. Foods rich in phytoestrogens include:

  • Soy Products: Tofu, tempeh, edamame, and soy milk.

  • Flaxseeds: These can be added to smoothies, yogurt, or baked goods.

  • Legumes: Chickpeas, lentils, and beans.


4. Boost Your Intake of Anti-Inflammatory Foods

Chronic inflammation can exacerbate urinary issues. Anti-inflammatory foods can help manage this:

  • Fruits and Vegetables: Particularly those high in antioxidants like berries, leafy greens, and bell peppers.

  • Omega-3 Fatty Acids: Found in fatty fish (salmon, mackerel, sardines), flaxseeds, and walnuts.

  • Herbs and Spices: Turmeric, ginger, and garlic have anti-inflammatory properties.


5. Probiotics and Prebiotics

A healthy gut microbiome can positively influence urinary tract health. Probiotics (beneficial bacteria) and prebiotics (food for these bacteria) can help maintain this balance:

  • Probiotic-Rich Foods: Yogurt, kefir, sauerkraut, kimchi, and other fermented foods.

  • Prebiotic Foods: Garlic, onions, bananas, asparagus, and whole grains.


When and Why It’s Important to See Your GP

While nutritional strategies can be beneficial, it’s crucial to recognize when to seek professional medical advice. Here are some signs that you should consult your GP:


1. Persistent or Severe Symptoms

If urinary issues are significantly impacting your quality of life or not improving with dietary changes, it's essential to seek medical advice. Persistent symptoms may require medical intervention.


2. Frequent UTIs

Recurrent urinary tract infections can lead to more serious complications if left untreated. If you experience frequent UTIs (more than two in six months or three in a year), consult your GP.


3. Blood in Urine

Blood in the urine, can be a sign of various underlying conditions that need prompt evaluation.


4. Pain or Discomfort

Persistent pain or discomfort in the pelvic area or during urination should be assessed by a healthcare professional to rule out infections or other conditions.


5. Incontinence

While occasional leakage can be managed with lifestyle changes, frequent or severe incontinence warrants a medical evaluation to explore treatment options.


6. Associated Symptoms

If urinary issues are accompanied by other concerning symptoms like unexplained weight loss, fever, or severe abdominal pain, seek medical advice promptly.


Working with Your GP

Your GP can offer a range of treatments to help manage urinary issues during perimenopause. These may include:

  • Medications: Such as anticholinergics for overactive bladder, antibiotics for UTIs, or low-dose vaginal oestrogen creams to improve tissue health.

  • Physical Therapy: Pelvic floor exercises can strengthen the muscles that support the bladder.

  • Behavioural Therapies: Bladder training and scheduled voiding can help manage symptoms.

  • Medical Devices: Pessaries or other devices may be recommended for certain types of incontinence.


In some cases, your GP might refer you to a specialist, such as a urologist or a gynaecologist, for further evaluation and treatment.


Urinary issues during perimenopause are a common but manageable aspect of this life stage. By understanding the role of hormonal changes, making strategic nutritional choices, and knowing when to seek medical advice, you can take proactive steps to manage your symptoms effectively. Remember, while diet and lifestyle adjustments can provide significant relief, professional medical guidance is crucial for persistent or severe symptoms to ensure comprehensive care and support. Empowering yourself with knowledge and support will help you navigate this transitional phase with greater ease and confidence.


If you would like support adjusting your everyday diet and lifestyle book in for a free chat with me. Click here to book.

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